I'm a prisoner of my own mind

I read an article last week that really made me think. The article (posted on the LA Times website – click here if you’d like to read the article) discussed the existing federal ban on harvesting organs from HIV-infected donors. On the surface, this law sounds like a good idea. But is it antiquated?

The article goes on to discuss the possibility of using HIV infected organs in patients who are already HIV positive. It says that as many as 20 people die per day while waiting on organ transplants.

This ban was implemented in 1984 (the year, not the book) when a diagnosis of HIV was considered a death sentence. True, there is no cure, but it has really become a “chronic illness” that, for many, can be controlled with medication.

The prospect of using HIV infected organs in HIV positive patients is one thing (and there is currently a lot of uncertainty regarding other possible risks to the patients). There’s also the prospect of “freeing up” the non-infected organs for the people who do not have HIV…but it got me to thinking: what if I needed an organ to live and the ONLY way for me to live was to infect me with HIV?

It’s not necessarily a simple question to answer, but it is thought provoking to say the least. Think about it: would you rather live with HIV or not live at all? Would you rather die than have to live a very careful life as not to infect others? What cost are you willing to put on having more time with the people you love? If you believe in an afterlife, is it better to pass from this life to the next rather than incurring MORE medical bills and possibly infecting the people you love?

I don’t know; maybe for some that choice would be easier than for others, but it seems to me that it’s certainly worth thinking about.

11 responses to “Could HIV Save Your Life?”

You know, Jessica, Crystal and I both wondered what your thoughts might be on the subject since you lost your brother to AIDS. I’m glad you chimed in.

It’s true that medicine has come a long way with regard to the HIV virus. It’s also true that there is no cure and that it would, eventually, turn into something terrible.

I guess my main point in posting this was to express the question “to what extent would people go to get more time?”

Time is a precious “commodity” that can’t be “saved” or kept for later. You either use it well or you don’t, but when it runs out, it’s gone. I know that many are willing to accept when “time’s up” but I also know that many would choose to extend their life at all costs whether it be due to a fear of death or regrets of things left undone or, as Sandra said, hoping to be there for the people that need you. Whatever the reason, there are certainly a lot of facets to consider.

Talk about thought provoking! I’ve been thinking about this all weekend. Having lost my brother to AIDS in the early 90’s, Im not sure extending one’s life to possibly deal with that in the future is something I’d consider doing. That is brutal and not something I’d wish on my worst enemy. However, I do know that HIV treatment is way different than back then when my brother contracted the virus and didn’t even know it until it had progressed into full blown AIDS. I’m not a microbiologist so I don’t know the ins and outs of viruses and how their different strains can affect people or mutate. As a layperson, I would have no problem with an already HIV infected patient taking an HIV infected organ if they so chose, but I admit to being naive as to what can of worms that may open.Jessica Sieghart´s last blog post ..Without A Peep

A virus is not a living organism! (That’s why antibiotics have no effect on a viral infection.)It does not “reproduce”… it “replicates” itself by penetrating a living cell and using it components to replicate. It must find a virus specific receptor site on a living cell in order to do so. (Under a scope, a virus looks something like a snowflake or an alien spaceship.) It doesn’t make just one virus but many and, when it’s depleted the living cell, the cell membrane ruptures and the little buggers move on to other cells. It when a virus is introduced into the body and finds no specific receptor site, it can..but not always.. mutate to available receptors. This is especially true of the “enveloped” virus like HIV and influenza. ………. Thus endeth today microbiology lecture! LOL

I’m pretty sure the complications would mostly stay within the individual since viruses reproduce asexually. I’d be more concerned with how hard it would be to treat an individual that had a foreign mutation of the virus introduced into their already compromised system. Maybe it’s an unwarranted concern though, since the virus mutates on a regular basis anyway. Who knows?

I guess a scientist would have to answer that. What kind of a monster virus could you create by combining 2 virus together, identical or not. and if this combination created obstacles in treating the new virus. then the person was irresponsible and spread the disease and the scientists have no medicine that can tame it. Sorry, I am not as intelligent sounding as you and Phyllis, but I am sure you get my point.

That’s the thing, though. There are no guarantees. There are no guarantees that a healthy organ would do you much better. There are all kinds of possible complications and in this case, I think the only guarantee is that you would become infected with HIV. BUT, if it were that with the possibility of extending your life or certain death in a few short days/hours…I think it gives you pause. And there’s always the other side of the consideration; (just playing “devil’s advocate” here) how selfish of a choice would this really be? Yeah, you might have the intentions of taking care of your loved ones, but what about the potential burden you would eventually become by having the disease. Don’t get me wrong…I don’t REALLY think that way…if my wife wanted to extend her life with a decision like this, I would lovingly care for her as long as either one of us lived. But it’s more to think about.

At least at this point in time, as far as I read, the consideration would really be only for use in already HIV infected patients…and in that regard (other than the obvious risks) is there REALLY much harm in allowing this type of transplant to occur?

That is a big IF. but IF I was on a transplant list and IF I knew it was very highly plausible that I would die before I could receive a non-HIV organ to extend my life. And IF I still had children living at home or dependent on me somehow, then I would most certainly accept an HIV infected organ IF that organ was relatively guaranteed to extend my life the same as a non-HIV organ. I can deal with having to be extra healthy, taking HIV meds and protecting my mate if it means I am able to live longer on earth to help the ones I love.

Age would certainly be a factor. I was thinking about that as I replied to your first comment.

Immediately after my reply I thought about “First do no harm” and decided that “harm” must have to be open to interpretation. Sure, by knowingly infecting a patient with HIV would be considered “harm”. But so would withholding treatment that could potentially extend life and possibly even (though temporarily) improve quality of life. It’s not unlike amputating a gangrenous limb to keep the rest of the body alive and well. Life would always be different, but it would be life. To your point, it depends on how dearly someone wants to cling on to life.

Again it comes back to… how badly does one want to cling to life? The variables on this subject are so broad. Would I, at this ripe old age, consider such an option. No. Perhaps my answer would be different were I considerably younger. Looking death in the face at almost 70 years old is quite different than it would be at say 20, 30, 40, even 50 years of age. … I’d be curious about the medicos take on the subject having taken the solemn oath of “first do no harm”. … It’s a subject certainly deserving of careful consideration!

Provocative commentary, Phyllis. There are certainly plenty of reasons against doing it. And you’re right, it is more of a life extension than life saving, but isn’t that true for any operation performed when the alternative is certain death? I know, I’m getting into semantics, but is that not what people often consider saving their life; extending their life when it would have otherwise ended sooner?

Unless I misread the article (and I could be remembering wrong, because it’s been over a week since I read it) I was left with the impression that organ transplants already take place on HIV positive patients. If thats true, the risk of operating on them really isn’t the question. But other complications you mentioned most certainly could be. What could happen if two different mutant strains of HIV were in the system of someone whose immune system is compromised?

But what I found so thought provoking (which was not in the original article, I think) was the prospect of receiving an HIV infected organ if it was somehow the only option of extending one’s life. What if a person’s liver failed and they were days if not hours from certain death. What if the only available liver was from someone who was dying from pneumonia because their immune system was shot from battling HIV? Sure, there are lots of factors to consider, but should the option at least be there?

I’m not necessarily saying that it should…but again, it makes me think.

I think it more a question of… Could HIV “extend” your life?… as it would indeed bring with it changes that could not be predetermined.

There are now strains of the HIV that are, themselves, immune to current medications. The HIV is highly mutable. How would transplanting a virus carrying organ into a different environment affect the ability of the virus to mutate? Many HIV positive patients who go along for a period of time symptom free suddenly find that the medications are no longer effective. … Since the majority of transplants serve only to add a few years to ones’ life, not save it to its’ normal expectancy, it becomes of question of how badly does one want to cling to life and what kind of life would it be. Transplant patients take massive medications to knock out their immune system in an effort to keep the body from rejecting transplanted organ(s). Could it then be that this comprised immune system would render HIV meds ineffective or provide an environment for mutation? Would the recipent be more susceptible to a quicker onset of full blown aids? I don’t know. … Then I think of the medical team, the surgical team who would be putting themselves at risk.. and to what end. The risk is low but does exist. Operating on an HIV positive patient carries with it greater risk than providing medical treatment to a positive patient. … Now, at the risk of sounding insensitive, there is the cost factor. I think we can agree upfront that no insurance company would cover the transplant procedure of an HIV organ nor the meds required pre and post-op. Few people, certainly no one I know, could afford to pay for it out of pocket. And if and when things go wrong, there’ll be another ad on TV for ambulance chasing lawyers..”If you or a loved one…etc., etc.” … Lastly, it’s already established that there is a high risk of contracting cancer in using organs or marrow from a patient who dies of cancer. Is there a correlation there between cancer and HIV? Again, I don’t know.

So… not being a medical professional but merely a “thinking person”, I would have to say I think the ban on transplanting HIV infected organs should remain in place. JMHO